Organization
CORAZON DEL OSO HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANUEL JUDE BACA SR. (PRACTICE MANAGER OPERATOR)
(505) 661-9030
Entity
Organization
Contact information
Practice address
3917 WEST RD STE 138, LOS ALAMOS, NM 87544-5307
(505) 661-9030
(505) 661-9666
Mailing address
138 ARAGON AVE, LOS ALAMOS, NM 87544-3502
(505) 661-9030
(505) 661-9030
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/26/2006
Last updated
08/22/2020
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